Experiences and outcomes of nurses referred to a peer health assistance program: Recommendations for nursing management

Comparing nurses attending a specialised mental health programme with and without substance use disorder: a retrospective, observational study in Spain

OBJECTIVES

To analyse the differences between nurses with and without substance use disorders (SUDs) admitted to a specialised mental health programme.

DESIGN

Retrospective, observational study.

SETTING

Specialised mental health treatment programme for nurses in Catalonia, Spain.

PARTICIPANTS

1091 nurses admitted to the programme from 2000 to 2021.

INTERVENTIONS

None.

PRIMARY AND SECONDARY OUTCOMES

Sociodemographic, occupational and clinical variables were analysed. Diagnoses followed Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision criteria.

RESULTS

Most nurses admitted to the programme were women (88%, n=960) and came voluntarily (92.1%, n=1005). The mean age at admission was 45 (SD=10.4) years. The most common diagnoses were adjustment disorders (36.6%, n=399), unipolar mood disorders (25.8%, n=282), anxiety disorders (16.4%, n=179) and SUDs (13.8%, n=151). Only 19.2% (n=209) of the sample were hospitalised during their first treatment episode. After multivariate analysis, suffering from a SUD was significantly associated with being a man (OR=4.12; 95% CI 2.49 to 6.82), coming after a directed referral (OR=4.55; 95% CI 2.5 to 7.69), being on sick leave at admission (OR=2.21; 95% CI 1.42 to 3.45) and needing hospitalisation at the beginning of their treatment (OR=12.5; 95% CI 8.3 to 20).

CONCLUSIONS

Nurses with SUDs have greater resistance to voluntarily asking for help from specialised mental health treatment programmes and have greater clinical severity compared with those without addictions. SUDs are also more frequent among men. More actions are needed to help prevent and promote earlier help-seeking behaviours among nurses with this type of mental disorder.

Clinical Competence of Nurses and the Associated Factors in Public Hospitals of Gamo Zone, Southern Ethiopia: A Cross-Sectional Study

Introduction

Nursing competency is an essential component for improving the quality of care in the healthcare system. However, assessing competency solely on the dimensions of skills and knowledge does not provide complete picture of a nurse ability to provide quality patient care. This is because it lacks focus on the nurse's attitudes and values, which are also important determinants of clinical competence. Therefore, this study aimed to assess the comprehensive clinical competence of nurses and its associated factors in public hospitals of Gamo Zone, Southern Ethiopia.

Materials and Methods

A cross-sectional study was conducted using a census method to collect information from nurses through self-administered questionnaires. The data were entered into EpiData version 3.1 and exported to Stata version 15 for analysis. A linear regression model was used to identify factors associated with clinical competence.

Results

In this study, the average clinical competence of nurses was 177.32, with a standard deviation of 19.19, and 31.2% of the respondents had a high level of clinical competence. Associated factors identified with clinical competence include gender, age, marital status, qualification, position, work experience, unit, interest in their profession, critical thinking disposition, clinical self-efficacy, and emotional intelligence.

Conclusions

The overall level of clinical competence among nurses in this study was moderate. As such, nurses improve their clinical competence by receiving training and development opportunities that focus on critical thinking, clinical self-efficacy, and emotional intelligence; working in a supportive work environment that encourages them to take risks and learn from their mistakes; and being monitored and coached on a regular basis.

Role of Stigma for Health Care Professionals With Nonmedical Substance Use

BACKGROUND

Stigma toward those with non-medical substance use may present as anticipated, perceived, enacted, or internalized stigma.

OBJECTIVE

The purpose of the study was to describe the role of stigma on health care professionals with non-medical substance use, from the perspective of treatment providers. Soliciting information about stigma from treatment providers is a unique perspective lacking in current literature.

METHODS

A qualitative descriptive design was used with semi-structured interviews of treatment providers (N = 16) in Colorado. Inductive content analysis was used to identify concepts and themes across interviews.

RESULTS

Findings showed that stigma is a major concern and a barrier for health care professionals seeking substance use treatment. Nurses and physicians demonstrate shame and guilt (internalized stigma) around their substance use. These professionals also experience fear around their reputation (perceived stigma) and challenges around re-entry to the workforce after treatment (anticipated stigma).

CONCLUSIONS

The awareness of existing stigma as well as internalized stigma impacts how health care professionals approach treatment, recovery, and returning to work.

Association between hopelessness and job burnout among Chinese nurses during the COVID-19 epidemic: The mediating role of career calling and the moderating role of social isolation

Background

The COVID-19 pandemic has led to an increased workload and work pressure on nurses owing to the unpredictable changes during this challenging situation. Herein, we explored the relationship between hopelessness and job burnout in nurses working in China against the backdrop of the COVID-19 outbreak.

Method

This was a cross-sectional study involving 1216 nurses in two hospitals in Anhui Province. The data was collected using an online survey. The mediation and moderation model was constructed, and the data was analyzed using SPSS PROCESS macro software.

Results

Our results showed that the nurses had an average job burnout score of 1.75 ± 0.85. Further analysis revealed a negative correlation between hopelessness and career calling (r = -0.551, P < 0.01) and a positive correlation between hopelessness and job burnout (r = 0.133, P < 0.01). Additionally, a negative correlation was demonstrated between career calling and job burnout (r = -0.138, P < 0.01). Moreover, career calling strongly mediated (by 40.9%) the relationship between hopelessness and job burnout in the nurses. Finally, social isolation in the nurses was a moderating factor for the association between hopelessness and job burnout (β = 0.028, t = 2.851, P < 0.01).

Conclusion

Burnout severity in nurses increased during the COVID-19 pandemic. Career calling mediated the relationship between hopelessness and burnout, with greater burnout levels in nurses who experienced social isolation. Therefore, we suggest that job burnout in nurses can be improved by mitigating the effects of hopelessness and social isolation through psychological interventions and enhancing their sense of career calling through education to strengthen their professional identity.

American Academy of Nursing Expert Panel Consensus Statement on leveraging equity in policy to improve recognition and treatment of mental health, substance use disorders, and nurse suicide

Rates of nurse mental health and substance use disorders are high. Heightened by the COVID-19 pandemic, nurses are challenged to care for patients in ways that often jeopardize their own health and increase risks for their families. These trends exacerbate the epidemic of suicide in nursing underscored by several professional organization clarion calls to nurses' risk. Principles of health equity and trauma-informed care dictate urgent action. The purpose of this paper is to establish consensus among clinical and policy leaders from Expert Panels of the American Academy of Nursing about actions to address risks to mental health and factors contributing to nurse suicide. Recommendations for mitigating barriers drew from the CDC's 2022 Suicide Prevention Resource for Action strategies to guide the nursing community to inform policy, education, research, and clinical practice with the goals of greater health promotion, risk reduction, and sustainment of nurses' health and well-being are provided.

An Integrative Review of Programs for Managing Nurses' Substance Use Disorder in the Workplace

BACKGROUND

Nurses' substance use disorder (SUD) endangers patient safety and decreases nurses' work ability and health. To better understand the methods, treatments, and benefits of the programs used to monitor nurses with SUD and promote their recovery, a systematic review of international research is needed.

AIM

The aim was to gather, evaluate, and summarize empirical research on programs for managing nurses with SUD.

DESIGN

An integrative review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis instructions.

METHOD

Systematic searches were conducted in the CINAHL, PsycInfo, PubMed, Scopus, and Web of Science databases between 2006 and 2020, complemented with manual searches. Articles were selected based on inclusion, exclusion, and method-specific evaluation criteria. The data were analyzed narratively.

RESULTS

The review identified 12 studies of which nine focused on recovery and monitoring programs for nurses with SUD or other impairment and three concerned training programs for nurse supervisors or worksite monitors. The programs were described in terms of their target groups, goals, and theoretical basis. The programs' methods and benefits were described together with challenges in their implementation.

CONCLUSION

There has been little research on programs for nurses with SUD, the programs that exist are heterogenous, and the evidence available in this field is weak. Further research and developmental work are needed on preventive and early detection programs as well as rehabilitative programs and programs supporting reentry to workplaces. In addition, programs should not be restricted to nurses and their supervisors; colleagues and work communities should also be involved.

Nurse admissions at a specialized mental health programme: A pre-Covid-19 retrospective review (2000-2019)

AIMS

Nursing is a stressful and emotionally demanding profession. To date, few mental health treatment interventions have been developed for them worldwide. This study aims to explore referral trends in nurses with mental disorders admitted to a pioneer specialized mental health programme in Europe from 2000 to 2019.

DESIGN

A retrospective observational study of 1297 medical e-records of nurses with mental health disorders admitted to the Galatea Care Programme in Barcelona was conducted.

METHODS

Three periods were analysed: 2000-2006, 2007-2012 and 2013-2019. Socio-demographic and clinical variables were compared. Diagnoses followed Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria.

RESULTS

Gender and age at referral did not change over time. Self-referrals grew from 85.1% in the first period to 95.3% in the last period; inpatient admissions decreased from 24.1% to 18.2%, although this was not significant; nurses were less frequently on sick leave on admission over time (59.1% vs. 45.7%); they were more likely to have a temporary contract in the second period (9.5% vs. 4.8% and 4%) and prevalence of main diagnosis changed with a considerable decrease in affective and substance use disorders after 2006 and a progressive increase in adjustment disorders during the whole period.

CONCLUSION

Free, voluntary, highly confidential programmes for nurses with mental disorders may enhance voluntary and earlier help seeking. These findings can be considered when implementing specialized interventions for them in other settings. WHAT PROBLEM DID THE STUDY ADDRESS?: Nursing is a stressful and emotionally demanding profession. To date, few specialized mental health services have been developed for them worldwide. This study aims to explore referral trends in nurses with mental disorders admitted to a pioneer programme in Europe, the Galatea Care Programme in Barcelona, from 2000 to 2019. WHAT WERE THE MAIN FINDINGS?: The number of referrals to the programme grew especially after the first 7-year period. Admissions were more likely to be voluntary during the last period. Prevalence of substance use disorders at admission dropped steadily while prevalence of adjustment disorders progressively increased over the two decades. Nurses were also less likely to be on sick leave at admission. WHERE AND ON WHOM WILL THE RESEARCH HAVE IMPACT?: Free, voluntary, highly confidential programmes for nurses with mental disorders may enhance voluntary and earlier help seeking. These findings can be considered when implementing specialized interventions for them in other settings.

The Nurse Leader's Role in Nurse Substance Use, Mental Health, and Suicide in a Peripandemic World

Nurses are known to be at an increased risk of death by suicide, and recent studies have found links between nurse suicide, substance use, mental health issues, and job problems. Because of stigma, inaccessibility of resources, and regulatory and legal issues, nurses are unlikely to seek help unless a crisis forces them into treatment. The purpose of this article is to review the current understanding of nurse suicide, the psychological impact of the novel coronavirus (COVID-19) pandemic, the strategic planning approach to identify the needs of nurses, and promising interventions and practices. Evidence-based strategies to intervene at the personal, institutional, and regulatory levels should be employed to reduce nurse suicide by focusing not only on suicide but also on treatment of substance and mental health issues, as well as a renewed focus on disciplinary procedures that may place nurses in immediate danger of death by suicide. Nurse leaders have a moral obligation to provide proactive, meaningful interventions to reduce the risk of death by suicide among nurses.